Journal of NeuroEngineering and Rehabilitation最新文献

{"title":"Hidden Markov model-based similarity measure (HMM-SM) for gait quality assessment of lower-limb prosthetic users using inertial sensor signals.","authors":"Gabriel Ng, Jan Andrysek","doi":"10.1186/s12984-025-01638-4","DOIUrl":"10.1186/s12984-025-01638-4","url":null,"abstract":"<p><strong>Background: </strong>Gait quality indices, such as the Gillette Gait Index or Gait Profile Score (GPS), can provide clinicians with objective, straightforward measures to quantify gait pathology and monitor changes over time. However, these methods often require motion capture or stationary gait analysis systems, limiting their accessibility. Inertial sensors offer a portable, cost-effective alternative for gait analysis. This study aimed to evaluate a novel hidden Markov model-based similarity measure (HMM-SM) for assessing gait quality directly from gyroscope and accelerometer data captured by inertial sensors.</p><p><strong>Methods: </strong>Walking trials were conducted with 26 lower-limb prosthetic users and 30 able-bodied individuals, using inertial sensors placed at various lower body locations. We computed the HMM-SM score along with other established inertial sensor-based methods, including the Movement Deviation Profile, Dynamic Time Warping, IMU-based Gait Normalcy Index, and Multifeature Gait Score. Spearman correlations with the GPS, a validated measure of gait quality, were assessed, as well as correlations among the inertial sensor methods. Welch's t-tests were used to evaluate the ability to distinguish between prosthetic subgroups.</p><p><strong>Results: </strong>The HMM-SM and other inertial sensor-based methods demonstrated moderate-to-strong correlations with the GPS (0.49 <|r|< 0.77 for significant correlations). Comparisons between different measures highlighted key similarities and differences, both in correlations and in their ability to differentiate between subgroups. Overall, the pelvis and lower leg sensors achieved significant correlations and outperformed the upper leg sensors, which did not achieve significant correlations with the GPS for any of the signal-based measures.</p><p><strong>Conclusion: </strong>Results suggest inertial sensors located at the pelvis and lower leg provide valid markers for monitoring overall gait quality, offering the potential to develop nonobtrusive, wearable systems to facilitate long-term monitoring. Such systems could enhance rehabilitation by enabling continuous gait assessment that can be easily integrated in clinical and everyday settings.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"109"},"PeriodicalIF":5.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12070658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing the dynamic treatment regime of outpatient rehabilitation in patients with knee osteoarthritis using reinforcement learning.","authors":"Sijia Liu, Jiawei Luo, Chengqi He","doi":"10.1186/s12984-025-01609-9","DOIUrl":"https://doi.org/10.1186/s12984-025-01609-9","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (KOA) is a prevalent chronic disease worldwide, and traditional treatment methods lack personalized adjustment for individual patient differences and cannot meet the needs of personalized treatment.</p><p><strong>Methods: </strong>In this study, a dedicated knee osteoarthritis bank (KOADB) was constructed by collecting extensive clinical data from patients. Random forest was used to select the features that had the greatest impact on treatment decisions from 122 questionnaire items. The questionnaire design was optimized to reduce the burden on patients and ensure the validity of data collection. Then, based on the key features screened out, a dynamic treatment recommendation system was constructed by using deep reinforcement learning algorithms, including Deep Deterministic Policy Gradien(DDPG), Deep Q-Network(DQN) and Batch-Constrained Q-learning(BCQ). A large number of simulation experiments have verified the effectiveness of these algorithms in optimizing the treatment strategy of KOA. Finally, the applicability and accuracy of the model were evaluated by comparing the treatment behaviors with actual patients.</p><p><strong>Results: </strong>In the application of deep reinforcement learning algorithms to treatment optimization, the BCQ algorithm achieves the highest success rate (79.1%), outperforming both DQN (68.1%) and DDPG (76.2%). These algorithms significantly outperform the treatment strategies that patients actually receive, demonstrating their advantages in dealing with dynamic and complex decisions.</p><p><strong>Conclusions: </strong>In this study, a deep learning-based KOA treatment optimization model was developed, which was able to adjust the treatment plan in real time and respond to changes in patient status. By integrating feature selection and reinforcement learning techniques, this study proposes an innovative method for treatment optimization, which offers new possibilities for chronic disease management and demonstrates certain feasibility in the development of personalized medicine and precision treatment strategies.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"107"},"PeriodicalIF":5.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gait speed-dependent modulation of paretic versus non-paretic propulsion in persons with chronic stroke.","authors":"Joost Biere, Brenda E Groen, Carmen J Ensink, Jorik Nonnekes, Noël L W Keijsers","doi":"10.1186/s12984-025-01620-0","DOIUrl":"https://doi.org/10.1186/s12984-025-01620-0","url":null,"abstract":"<p><strong>Background: </strong>Persons with chronic stroke (PwCS) exhibit impaired paretic propulsion generation. Consequently, PwCS walk slower than healthy peers and rely more on their non-paretic leg, leading to propulsion asymmetry. However, it remains unclear how propulsion symmetry is influenced by walking at various gait speeds. This study aimed to investigate the relation between gait speed and propulsion symmetry in PwCS and controls.</p><p><strong>Methods: </strong>Fifteen PwCS and sixteen healthy controls walked on an instrumented treadmill at randomized speeds, ranging from 0.2 m/s to comfortable walking speeds for PwCS or 0.4 to 1.6 m/s for controls, with 0.2 m/s increments. PwCS continued to their maximum speed with 0.1 m/s increments. Propulsion, derived from the anteroposterior component of the ground reaction force, was defined as propulsion peak and propulsion impulse. The primary outcome was propulsion peak and impulse symmetry (paretic propulsion / total propulsion), with secondary outcomes being propulsion peak and impulse per leg. The relationship between gait speed and propulsion metrics was analyzed using linear mixed models (LMM).</p><p><strong>Results: </strong>PwCS exhibited clear propulsion peak and impulse asymmetry across all gait speeds, while controls maintained symmetrical propulsion. LMMs revealed no change in propulsion peak symmetry with gait speed (β = 0.12, SE = 0.090, p = 0.19), with considerable variability among PwCS. Propulsion impulse symmetry improved with increasing gait speed (β = 0.39, SE = 0.048, p < 0.001), especially in PwCS who had greater asymmetry at comfortable walking speed. Propulsion peak and impulse increased with gait speed in both legs for PwCS and controls. The propulsion peak increase was stronger in the non-paretic compared to the paretic leg (0.16 ± 0.043 vs. 0.12 ± 0.042 N/kg per 0.1 m/s), while the propulsion impulse increase was similar between legs.</p><p><strong>Conclusions: </strong>PwCS showed reduced paretic leg contribution to forward propulsion across various gait speeds. The relative paretic contribution for propulsion peak remained constant while it increased with gait speed for propulsion impulse, especially in those with greater asymmetry at their comfortable walking speed. Furthermore, all participants were able to increase paretic propulsion peak and impulse above their propulsion at comfortable walking speed, suggesting some residual paretic capacity.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"108"},"PeriodicalIF":5.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063273/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multi-label deep residual shrinkage network for high-density surface electromyography decomposition in real-time.","authors":"Jinting Ma, Lifen Wang, Renxiang Wu, Naiwen Zhang, Jing Wei, Jianjun Li, Qiuyuan Li, Lihai Tan, Guanglin Li, Naifu Jiang, Guo Dan","doi":"10.1186/s12984-025-01639-3","DOIUrl":"https://doi.org/10.1186/s12984-025-01639-3","url":null,"abstract":"<p><strong>Background: </strong>The swift and accurate identification of motor unit spike trains (MUSTs) from surface electromyography (sEMG) is essential for enabling real-time control in neural interfaces. However, the existing sEMG decomposition methods, including blind source separation (BSS) and deep learning, have not yet achieved satisfactory performance, due to high latency or low accuracy.</p><p><strong>Methods: </strong>This study introduces a novel real-time high-density sEMG (HD-sEMG) decomposition algorithm named ML-DRSNet, which combines multi-label learning with a deep residual shrinkage network (DRSNet) to improve accuracy and reduce latency. ML-DRSNet was evaluated on a public sEMG dataset and the corresponding MUSTs extracted via the convolutional BSS algorithm. An improved multi-label deep convolutional neural network (ML-DCNN) was also evaluated and compared against a conventional multi-task DCNN (MT-DCNN). These networks were trained and tested on various window sizes and step sizes.</p><p><strong>Results: </strong>With the shortest window size (20 data points) and step size (10 data points), ML-DRSNet significantly outperformed both ML-DCNN (0.86 ± 0.18 vs. 0.71 ± 0.24, P < 0.001) and MT-DCNN (0.86 ± 0.18 vs. 0.66 ± 0.16, P < 0.001) in decomposition precision. Moreover, ML-DRSNet demonstrated a notably lower latency (15.15 ms) compared to ML-DCNN (69.36 ms) and MT-DCNN (76.96 ms), both of which demonstrated reduced latency relative to BSS-based decomposition methods.</p><p><strong>Conclusions: </strong>The proposed ML-DRSNet and the improved ML-DCNN algorithms substantially enhance both the accuracy and real-time performance in decomposing MUSTs, establishing a technical foundation for neuro-information-driven motor intention recognition and disease assessment.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"106"},"PeriodicalIF":5.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12060341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144017511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"User accommodation to an active microprocessor-controlled knee in individuals with unilateral transfemoral amputation: a 5-week non-randomized trial.","authors":"Elke Lathouwers, Alexandre Maricot, Bruno Tassignon, Sybille Geers, Louis Flynn, Tom Verstraten, Kevin De Pauw","doi":"10.1186/s12984-025-01637-5","DOIUrl":"https://doi.org/10.1186/s12984-025-01637-5","url":null,"abstract":"<p><strong>Background: </strong>Evaluation studies on active microprocessor-controlled knees (AMPK) in individuals with unilateral transfemoral amputation (TFA) are lacking in the literature. Furthermore, research on user accommodation to AMPK remains to be investigated. Hence, this study aims to conduct a comparison between an AMPK and individual's current prosthesis and assess the accommodation to using an AMPK during daily activities over a 5-week period on functional performance tests.</p><p><strong>Methods: </strong>Participants with TFA completed a protocol comprising L-test, slope walking, level walking (2MWT) and dual-task level walking (dual-2MWT) once a week with their current prosthesis and the AMPK. The outcomes of interest were the distance covered during the 2MWT and dual-2MWT, time required to perform the L-test, accuracy of the serial subtractions during the dual-2MWT, heart rate (HR), rating of perceived exertion, fatigue, comfort and perceived workload. Generalised least-squared models were built to investigate differences in prosthetic conditions over time. Pearson correlations were calculated to determine associations between the performance and subjective outcomes. The level of significance was set at 0.05.</p><p><strong>Results: </strong>Seven participants (age = 53 years ± 14 years) completed the study. Over time, the AMPK participants took longer to complete the L-test than their current prosthesis (p < 0.001). They reported higher fatigue (p = 0.033), lower comfort (p = 0.010), and higher perceived exertion with the AMPK (p = 0.048). Slope walking showed no significant walking speed or HR differences except higher HR with the AMPK in session 3 (p = 0.032). Dual-task level walking demonstrated lower walking speed with the AMPK (p = 0.035) and more responses to serial subtractions in sessions two (p = 0.043) and four (p = 0.023). No other differences between conditions were found on one of the functional tests. Weak associations (|r|= 0-0.5) were observed between performance and subjective measures.</p><p><strong>Conclusion: </strong>Using the AMPK highlights initial challenges in task completion times and subjective comfort and fatigue levels. Our findings indicate that five one-hour sessions are insufficient for achieving user accommodation, and underscore the need for further research with a larger sample, continued prosthetic use and user accommodation to enhance prosthetic functioning and user experiences.</p><p><strong>Trial registration: </strong>NCT05407545.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"105"},"PeriodicalIF":5.2,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12057274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing anticipation control of the posture system in the elderly wearing stroboscopic glasses.","authors":"Yi-Ching Chen, Yi-Ying Tsai, Yen-Ting Lin, Ing-Shiou Hwang","doi":"10.1186/s12984-025-01549-4","DOIUrl":"https://doi.org/10.1186/s12984-025-01549-4","url":null,"abstract":"<p><strong>Background: </strong>Stroboscopic vision (SV), known for providing intermittent visual input, has been recently integrated into postural training to improve proprioceptive awareness. This research examined the impact of SV on cortico-posture coupling in older adults, along with the related changes in postural control throughout a spectrum of feedback and feedforward processes.</p><p><strong>Methods: </strong>A total of thirty-three adults, averaging 66.1 ± 2.5 years of age, were tasked with maintaining an upright posture on a stabilometer, utilizing either complete or intermittent visual guidance. Stabilogram diffusion analysis (SDA) was employed to assess balance strategies based on postural sway, while phase-amplitude coupling (PAC) between postural fluctuations and scalp EEG provided insights into the associated neural control mechanisms.</p><p><strong>Results: </strong>SV resulted in significantly increased postural sway as compared with that of full-vision feedback (p < 0.001). SDA results indicated greater critical point displacement (CD) (p < 0.001), short-term diffusion coefficients (Ds) (p < 0.001), and scaling exponents (Hs) (p = 0.014) under SV conditions. PAC analysis revealed that the coupling between the postural fluctuation phase and cortical oscillation amplitude in the theta and alpha bands of the fronto-central area was significantly greater in the SV condition than in the full-vision condition (p < 0.001). Additionally, SV led to increased beta PAC in the frontal and sensorimotor areas compared to that of full vision (p < 0.001), which negatively correlated to SV-dependent changes in open-loop gain (Hs) (p < 0.05).</p><p><strong>Conclusions: </strong>SV transitions postural sway towards an open-loop process and influences cortico-posture interactions in older adults, emphasizing a neuromotor adaptation to the uncertainty in feedforward predictions when utilizing intermittent visual feedback.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"104"},"PeriodicalIF":5.2,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144063903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Muscle weakness but also contractures contribute to the progressive gait pathology in children with Duchenne muscular dystrophy: a simulation study.","authors":"Ines Vandekerckhove, Lars D'Hondt, Dhruv Gupta, Bram Van Den Bosch, Marleen Van den Hauwe, Nathalie Goemans, Liesbeth De Waele, Anja Van Campenhout, Kaat Desloovere, Friedl De Groote","doi":"10.1186/s12984-025-01631-x","DOIUrl":"https://doi.org/10.1186/s12984-025-01631-x","url":null,"abstract":"<p><strong>Background: </strong>Muscle weakness and contractures cause gait deficits in children with Duchenne muscular dystrophy (DMD) but their relative contributions are poorly understood and hence it is unclear whether contractures should be treated. Therefore, we aimed to differentiate the effect of muscle weakness in isolation from weakness and contractures combined on the gait patterns.</p><p><strong>Methods: </strong>We used computer simulations that generate gait patterns based on a musculoskeletal model (without relying on experimental data) to establish the relationship between muscle impairments and gait deviations. We previously collected a longitudinal database of 137 repeated measurements in 30 boys with DMD and found that the data measured through 3D gait analysis could be clustered in three gait patterns. We estimated weakness based on data from fixed dynamometry, and contractures based on goniometry and clinical measures. Foot deformities were modeled by reducing the height of all foot segments and decreasing the strength of the intrinsic foot muscles. We created musculoskeletal models that either represented (1) the mean weakness; (2) the mean weakness and contractures; or (3) the mean weakness, contractures and foot deformities, in each gait pattern.</p><p><strong>Results: </strong>Simulations based on models with both weakness and contractures captured most (but not all) experimentally observed gait deviations, demonstrating the validity of our approach. While muscle weakness was primarily responsible for gait deviations, muscle contractures and foot deformities further contributed to gait deviations. Interestingly, the simulations predict that the combination of increasing weakness and contractures rather than increasing weakness alone causes loss of ambulation for the most affected gait pattern.</p><p><strong>Conclusions: </strong>Predictive simulations have the potential to elucidate causal relationships between muscle impairments and gait deviations in boys with DMD. In the future, they could be used to design targeted interventions (e.g. stretching, assistive devices) to prolong ambulation.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"103"},"PeriodicalIF":5.2,"publicationDate":"2025-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12051353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beat-aligned motor synergies and kinematic beat detection in street dance movements.","authors":"Keli Shen, Jun-Ichiro Hirayama","doi":"10.1186/s12984-025-01626-8","DOIUrl":"https://doi.org/10.1186/s12984-025-01626-8","url":null,"abstract":"<p><p>Dance is a rich artistic expression that combines intricate human movements with music, emotion, and cultural elements. However, the analysis of complex dance movements poses significant challenges because of the lack of comprehensive motion capture data and efficient computational techniques for feature extraction. In the current study, we present a novel time-dependent principal component analysis approach for extracting beat-aligned motor synergies from large street dance datasets. Unlike existing methods, our technique accounts for the temporal variability induced by music beats, enabling an accurate representation of dance motion patterns. The extracted motor synergies, capturing both spatial and temporal patterns across motion segments and beat durations, were analyzed to gain insights into motor coordination, consistency, similarity, and variability across different dance genres. This analysis facilitates the understanding of complex dance movements by summarizing them in a low-dimensional subspace, elucidating the common elements and coordinated modalities among various dance sequences segmented based on the timing of music beats. Furthermore, we demonstrated that kinematic beat detection was improved by leveraging the first motor synergy activation, enabling more accurate beat alignment and synchronization with the music, a crucial factor in dance performance and analysis. The enhancement of beat estimation accuracy was verified through cross-validation comparisons of beat alignment scores. This work offers a novel computational approach to analyzing and extracting meaningful patterns from complex dance motions for a deeper understanding of the motor mechanisms inherent in dance genres, enabling new insights into the intricate dynamics of dance movements and their relationships with music influences.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"102"},"PeriodicalIF":5.2,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12046673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143971739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activity-based recovery training with spinal cord epidural stimulation improves standing performance in cervical spinal cord injury.","authors":"Claudia A Angeli, Enrico Rejc, Beatrice Ugiliweneza, Maxwell Boakye, Gail F Forrest, Katelyn Brockman, Justin Vogt, Brittany Logsdon, Katie Fields, Susan J Harkema","doi":"10.1186/s12984-025-01636-6","DOIUrl":"https://doi.org/10.1186/s12984-025-01636-6","url":null,"abstract":"<p><strong>Background: </strong>Individuals with a clinically complete spinal cord injury are unable to stand independently without external assistance. Studies have shown the combination of spinal cord epidural stimulation (scES) targeted for standing with activity-based recovery training (ABRT) can promote independence of standing in individuals with spinal cord injury. This cohort study aimed to assess the effects of stand-ABRT with scES in individuals with cervical chronic spinal cord injury. We evaluated the ability of these individuals to stand independently from physical assistance across multiple sessions.</p><p><strong>Methods: </strong>Thirty individuals participated in this study, all unable to stand independently at the start of the intervention. Individuals were participating in a randomized clinical trial and received stand-ABRT in addition to targeted cardiovascular scES or voluntary scES. During the standing intervention, participants were asked to stand 2 h a day, 5 days a week for 80 sessions (Groups 1 and 2) or 160 sessions (Groups 3 and 4).</p><p><strong>Results: </strong>A total of 3,524 training days were considered for analysis. Group 1 had 507 days, group 2 with 578 days, and 1152 and 1269 days for groups 3 and 4 respectively. 71% of sessions reached the two-hour standing goal. All individuals achieved outcomes of lower limb independent extension with spinal cord epidural stimulation, with a wide range throughout a training day. Sixteen participants achieved unassisted hip extension while maintaining unassisted bilateral knee and trunk extension. Participants receiving initial voluntary scES training performed better in unassisted bilateral knee and trunk extension than those receiving initial cardiovascular scES. The lower-limb standing activation pattern changes were consistent with the greater standing independence observed by all groups.</p><p><strong>Conclusions: </strong>Individuals with chronic cervical spinal cord injury were able to achieve various levels of extension without manual assistance during standing with balance assist following stand-ABRT with scES. These results provide evidence that scES modulates network excitability of the injured spinal cord to allow for the integration of afferent and supraspinal descending input to promote standing in individuals with spinal cord injury.</p><p><strong>Trial registration: </strong>The study was registered on Clinical Trials.gov (NCT03364660) prior to subject enrollment.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"101"},"PeriodicalIF":5.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042302/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Methods to assess lower limb prosthetic adaptation: a systematic review.","authors":"Natali Olaya-Mira, Luz Marina Gómez-Hernández, Carolina Viloria-Barragán, Isabel Cristina Soto-Cardona","doi":"10.1186/s12984-024-01530-7","DOIUrl":"https://doi.org/10.1186/s12984-024-01530-7","url":null,"abstract":"<p><strong>Background: </strong>Lower limb amputation is a disabling condition with serious psychological, physical, and functional consequences. The adaptation of a prosthetic device can either mitigate or exacerbate these effects. Although many individuals receive lower limb prostheses, rejection rates remain high. Furthermore, while numerous objective and quantitative methods are available to assess the interface between the residual limb and the prosthetic socket, as well as the device performance, prosthetic fitting largely relies on prosthetists' observation and expertise. Accordingly, this review describes the most commonly employed methods for evaluating prosthetic fitting, emphasizing frequently used combinations of tools, devices, procedures, and tests for characterizing residual limbs and clinical outcomes, which indirectly contribute to prosthetic fitting evaluation.</p><p><strong>Main body: </strong>In July 2023, searches were conducted across the Taylor & Francis, SpringerLink, Sage, ScienceDirect, and Scopus databases, focusing on research papers, case reports, and technical briefs published between 2011 and 2023. Studies were selected by four reviewers, and any discrepancies were resolved through group discussions. The Rayyan tool was employed to ensure that the retrieved publications evaluated residual limb variables involved in prosthetic fitting. The predominant methods for assessing lower-limb prosthetic fitting include mobility evaluation, gait analysis, measurement of physical variables, and stability assessment. Functional tests and self-report questionnaires, which do not require specialized equipment or great expertise, are the most widely utilized techniques.</p><p><strong>Conclusions: </strong>The results demonstrate that, within clinical practice, mobility evaluation is the primary predictor of prosthetic fitting. Since methodologies for measuring more specific variables are often restricted to laboratory settings, future studies should analyze factors that could enable their implementation in clinical contexts.</p>","PeriodicalId":16384,"journal":{"name":"Journal of NeuroEngineering and Rehabilitation","volume":"22 1","pages":"100"},"PeriodicalIF":5.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}